GPs cannot and are not required to provide waiting list advice to patients beyond the point of referral, Northern Ireland’s Public Services Ombudsman (NIPSO) has said in a report published today.
The report, Forgotten – an investigation into healthcare waiting list communication, identified a lack of clarity around GPs’ role, responsibility and ability to provide waiting list information and said that the lack of communication had ‘not only had an impact on patients, it has also impacted on the resources of the Trusts and GPs due to the resulting level of enquiries and complaints’.
All Trusts were found to be failing to consistently comply with the requirement to send an acknowledgement to patients following receipt of their referral.
The investigation found that most GPs were not directly provided with general wait times by Trusts, and many were unfamiliar with the Integrated Elective Access Protocol (IEAP), concluding that Trusts’ apparent reliance on GPs to provide waiting list information to patients was therefore ‘misplaced’ and leading to potential confusion as to whom patients should be contacting for updates.
Approximately 23% of GPs in Northern Ireland responded to the report’s survey, of which 80% indicated that waiting list information was not easily accessible to them. It found 96% of GPs went as far as to suggest that major improvements were required and 94% said that providing waiting list information to patients placed a significant strain on their resources.
The Ombudsman’s investigation illustrated that the Department of Health and Trusts viewed GPs as a key partner in sharing waiting list and other communications with patients but found a ‘lack of coherence in how this works in practice’.
While 79% of GPs agreed that their role included provision of general waiting time information at the point of referral, many highlighted that Trusts failed to provide this information, limiting their ability to share this with patients.
Ombudsman Margaret Kelly’s finding was of ‘systemic maladministration’ and urged the Department to work ‘more cohesively’ with Trusts, GPs and patient representatives to address the need for improvement.
The report recommended providing waiting list information on Trust websites, engagement sessions with GPs to discuss patient communication and awareness of the IEAP, and the introduction of an acknowledgement template letter indicating clinical urgency, wait times, what to expect and who to contact for further information or change in circumstance. The report also said that updates should be provided to those waiting six months or longer.
Dr Alan Stout, BMA Northern Ireland GP committee chair, said: ‘Today’s report lays clear some of the issues faced by patients and doctors in terms of navigating an unnecessarily complex waiting list system. We all know that our waiting lists are far too long with average waiting times being years rather than weeks or months.’
He added: ‘Patients need to be seen in a timely manner, but they also need to be communicated with along that journey so they are not put in a position where they are chasing appointments themselves, or as the report highlights using GP time to chase appointments. Trusts need to communicate more effectively with patients, being open and honest about how long they are likely to wait for an appointment and treatment.
‘We would welcome the opportunity to work with Trusts to help address some of the issues highlighted by today’s report.’
A Department spokesperson said that thereport and recommendations would be ‘carefully considered’ and that it would continue to work with NIPSO, GPs and Trusts to enhance patient access to waiting time information.
The spokesperson said: ‘The Department fully appreciates the deep distress and frustration experienced by patients on waiting lists. While improved information provision is required, the ultimate solution is a sustained programme of investment and reform to reduce and eventually eliminate the current backlog of care. This backlog has taken years to build up and will take years to be fully addressed.
At last month’s UK LMC conference, it was said the waiting list for some specialties was up to nine years, with evidence of GPs being sued by patients experiencing long waits for hospital treatment.
Latest figures from the NI Department of Health showed that, as of March this year, of the patients waiting for a first consultant led outpatient appointment, almost 50% were waiting more than a year.